Title: Prevalence of Lower Limb Traction Apophysitis among Children with Low Vitamin D and Secondary Hyperparathyroidism - Ultra Sonographic Study
Authors: Ahmed Fathy Abogamal, Eman Mahmoud, Ahmed Aly Abdelaziz, Sameh Abdelatif, Mohammed Ahmed Hasuna Hemeda, Ahmed Fathy Abdalaziz, Maged A H Shoukeer
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.01
Abstract
Introduction: Traction apophysitis is a traction phenomenon resulting from repetitive load through the tendon or ligament at its insertion upon the skeletally immature bony insertion .Secondary hyperparathyroidism along with vitamin D deficiency have a major deleterious effect on the musculoskeletal system and may affect the traction points on the children age group.
Aim of the work: Is to investigate the prevalence of lower limb traction apophysitis among children with secondary hyperparathyroidism and low vitamin D.
Patients and Methods: Group I: 68 patients with Secondary hyperparathyroidism due to hypovitaminosis D; Group II: 50 normal children as a control group. All patients were subjected to clinical history taking, examination for the traction apophysitis sites in the lower limb, body mass index measurement, ultrasound assessment of Quadriceps tendon insertion, Infrapatellar ligament, Achilles tendon, and Plantar fascia.
Results: The ultrasound detected prevalence of traction apophysitis in the lower limb in the study group was 66.2 %, were 45 patients defined affected, among the affected patients 32 (71.1%) were male and 13(28.9%) were female. Ultrasound assessment of the control group shows that 10 (20%) patients affected by traction apophysitis; among the affected patients 8 (80%) were male and 2 (20%) were female.
Conclusion: Traction apophysitis appears to be frequent problem in children with secondary hyperparathyr-oidism and low vitamin D. The factors significantly associated with presence of traction apophysitis were increased parathyroid hormone and low vitamin D.
Keywords: traction apophysitis, secondary hyperparathyroidism, low vitamin D.
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